Lifting the Physical, Occupational and Speech Therapy Cap

Residents at Brooks-Howell and Medicare recipients throughout the country have reason to celebrate these days. Until recently, there was a cap on how much therapy could be provided in a calendar year under Medicare before the individual would have to pay out-of-pocket. But under a recent change in federal law with passage of the Bipartisan Budget Act of 2018, people who qualify for Medicare’s physical, occupational or speech therapy services will no longer lose coverage because they reached the cap. There is not an arbitrary limit on how long or how much Medicare will pay if the therapy is ordered by a doctor for those individuals with a chronic condition. The therapy must be medically necessary in order to maintain the patient’s condition or to prevent or slow decline.

At Brooks-Howell, some of our residents with chronic conditions may need a few weeks of therapy or may need more consistent therapy. This will enable them to continue to do everyday tasks for themselves as long as possible. It is a win-win situation because the more the resident can do for themselves, the better they feel about themselves. And it reduces the risk of back injuries of their spouse, caregiver or nursing staff who won’t have to do as much lifting of the resident, but can stand-by to assist and make sure the patient is safe.